Articlegreen2009

BLOOD DONORS AND BLOOD COLLECTION: Web interface–supported transmission risk assessment and cost‐effectiveness analysis of postdonation screening: a global model applied to Ghana, Thailand, and the Netherlands

Marinus van Hulst · Gijs A. A. Hubben · Kwamena William Coleman Sagoe · Charupon Promwong · Parichart Permpikul · Ladda Fongsatitkul +3 more

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Blood donation and transfusion practices Health Systems, Economic Evaluations, Quality of Life Blood transfusion and management

Abstract

BACKGROUND: The goal of our research was to actively involve decision makers in the economic assessment of screening strategies in their region. This study attempted to accomplish this by providing an easy-to-use Web interface at http://www.bloodsafety.info that allows decision makers to adapt this model to local conditions. STUDY DESIGN AND METHODS: The cost-effectiveness was compared of 1) adding antigen screening to antibody screening for hepatitis C virus (HCV) and human immunodeficiency virus (HIV); 2) adding nucleic acid amplification testing (NAT) on hepatitis B virus (HBV), HCV, and HIV in minipool (pool of 6 [MP6] and 24 [MP24]) to antibody screening and hepatitis B surface antigen (HBsAg) screening; and 3) individual-donation NAT on HBV, HCV, and HIV to antibody screening and HBsAg screening for Ghana, Thailand, and the Netherlands. RESULTS: The combination of HCV antibody-antigen combination (combo) and HIV combo added to antibody screening in Ghana and Thailand was cost-effective according to the WHO criteria. MP24-NAT screening in Ghana was also cost-effective. MP24-NAT on HBV, HCV, and HIV was not cost-effective compared to the other screening strategies evaluated for the Netherlands. Large regional differences in cost-effectiveness were found for Thailand. CONCLUSION: The young transfusion recipient population of Ghana in combination with a high risk of viral transmission yields better cost-effectiveness for additional tests. The advanced age of the transfused population of the Netherlands and a small risk of viral transmission gives poor cost-effectiveness for more sensitive screening techniques. It was demonstrated that a global health economic model combined with a Web interface can provide easy access to risk assessment and cost-effectiveness analysis.

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References

1996The Risk of Transfusion-Transmitted Viral Infections 1990World Development Report 1990.2005A new strategy for estimating risks of transfusion‐transmitted viral infections based on rates of detection of recently infected donors 2003The cost‐effectiveness of NAT for HIV, HCV, and HBV in whole‐blood donations 1997The incidence/window period model and its use to assess the risk of transfusion-transmitted human immunodeficiency virus and hepatitis C virus infection 1994Epidemiology of blood transfusion 2001Estimated risk of HIV transmission by blood transfusion in Kenya 2001Screening for viral markers in volunteer and replacement blood donors in West Africa

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2009Health economics of blood transfusion safety – focus on sub-Saharan Africa 2017Robust Postdonation Blood Screening Under Prevalence Rate Uncertainty 2016Residual risk and waste in donated blood with pooled nucleic acid testing 2013Human immunodeficiency virus prevalence, incidence, and residual transmission risk in first‐time and repeat blood donations in Z imbabwe: implications on blood safety 2014

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